Teen vaping is a topical issue, with parents and schools struggling to manage this amid fears that children are becoming addicted and harming their health, write Christina Watts, Becky Freeman and Sam Egger from the University of Sydney in The Conversation.
They write:
We have published, in the Australian and New Zealand Journal of Public Health, the first results from the Generation Vape study, which tracks teenagers’ knowledge, attitudes, beliefs and behaviours about using e-cigarettes, and our findings affirm our belief that illegal sales and imports of these products need to end.
More than than 700 teenagers were surveyed, aged 14-17 years old, from New South Wales. The sample was closely representative of the population, with key characteristics such as age, gender, location and education monitored throughout data collection.
We found found teenagers are readily accessing and using illegal, flavoured, disposable vaping products that contain nicotine. Among the teens surveyed, 32% had vaped at least a few puffs. Of these, more than half (54%) had never previously smoked.
Most teens (70%) didn’t directly buy the last vape they used. The vast majority (80%) of these got them from their friends.
However, for the 30% who did buy their own vape, close to half (49%) bought from a friend or another individual, and 31% bought it from a retailer such as a petrol station, tobacconist or convenience store.
Teens also said they bought vapes through social media, at vape stores and via websites.
What products are teens using, and why?
Of the teens who had ever vaped and reported the type of device they used, 86% had used a disposable vape. This confirms anecdotal reports. These devices appeal to young people and are easy to use. They do not require refilling (unlike tank-style vaping products) and are activated by inhaling on the mouthpiece.
Disposable vapes can contain hundreds, or even thousands of puffs, and are inexpensive, with illicit vapes from retail stores costing between $20-$30, or as little as $5 online.
There is an enormous range of vape flavours likely to appeal to children, from chewing gum to fruit and soft drink, even desserts. So it is unsurprising teens rated “flavourings and taste” as the most important characteristic of vapes they used.
Disposable vapes often contain very high concentrations of nicotine, even those claiming to be nicotine-free. The way these products are made (using nicotine salts rather than the free-base nicotine you’d find in cigarettes) allows manufacturers to increase the nicotine concentration without causing throat irritation.
In our study, more than half (53%) of the teens who had ever vaped said they had used a vape containing nicotine. Many, however, were unsure whether they had used a vape containing nicotine (27%).
All vaping products, irrespective of nicotine content, are illegal to sell to under 18s in Australia.
Today, disposable vapes containing nicotine can only be legally sold in Australia by pharmacies to adult users with a valid prescription.
We need to end illegal imports and sales
Our results emphasise that teen vaping is increasingly normalised, and the most popular devices are designed to be highly appealing to young people. This is despite product manufacturers and proponents claiming they are smoking cessation aids only for adult smokers who are struggling to quit.
Turning the tide on teen vaping requires strong and immediate policy action, including ending the illicit importation and sale of vaping products.
Education is often the default first action to address unhealthy behaviours in young people. However, unless this is coupled with strong, supportive policy action, this approach is unlikely to have any measurable impact. Education campaigns cannot protect young people from an industry that so freely disregards laws meant to protect health.
We have strong evidence that vaping leads to harms such as poisoning, injuries, burns, toxicity, addiction and lung injury. The odds of becoming a smoker is more than three times higher for never-smokers who vape than for never-smokers who don’t vape.
What’s next?
This study uses data from the first wave of the Generation Vape research project, a three-year study with Australian teenagers, young adults, parents and guardians of teenagers, and secondary school teachers.
Future waves of this repeat cross-sectional study, coupled with in-depth interviews, will allow us to track and monitor changes to adolescent, young adult, teacher, and parent attitudes, perceptions, and knowledge of vaping over time.
Vaping is a rapidly evolving public health crisis in Australia. Our research provides evidence for concerted policy action to prevent young people from accessing harmful and addictive products.
Failure to act will see a whole new generation of Australians addicted to dangerous products.
* Christina Watts is a Research Fellow, tobacco control, University of Sydney; Becky Freeman is Associate Professor, School of Public Health, University of Sydney; Sam Egger is a biostatistician, University of Sydney.
Study details
Vaping product access and use among 14–17-year-olds in New South Wales: a cross-sectional study
Christina Watts, Sam Egger, Anita Dessaix, Alecia Brooks, Emily Jenkinson, Paul Grogan, Becky Freeman.
Published in Australia/NZ School of Public Health Journal on 26 September 2022
Abstract
Objectives
We assessed access to vaping products and types of products used and the factors associated with vaping and smoking among young people in the state of New South Wales (NSW), Australia.
Methods
A cross-sectional survey was conducted with a sample of 721 young people aged 14 to 17 years from NSW recruited through online panels. Poisson regression with robust variance was used to estimate relative risks of ever-vaping and ever-smoking.
Results
Almost one-third of the sample (32%, n=233) reported being an ever-vaper, of which more than half (54%) had never smoked prior to starting vaping. Ever-vaping was independently associated with age and being Aboriginal or Torres Strait Islander, and ever-smoking was independently associated with being male. Ever-smokers were seven times more likely to be ever-vapers than those who had never smoked, and ever-vapers were 18 times more likely to be ever-smokers than those who had never vaped. Among ever-vapers who reported which type of device they were using, 86% reported the use of disposable products. “Flavourings and taste” was rated as the most important characteristic of vapes. More than half of ever-vapers reported getting the last vape they used from their friends (55%, n=130). More than half of ever-vapers had used a vape that they knew contained nicotine (53%, n=123).
Conclusions
Vaping was the strongest risk factor for smoking, and vice versa, suggesting there is not a straightforward, unidirectional relationship between vaping and smoking in young people. Young people appear to be readily accessing nicotine vaping products, which are often disposable and flavoured, through both social and commercial channels.
Implications for public health
Stronger enforcement of federal and state policies designed to protect young people from vaping products is urgently needed.
See more from MedicalBrief archives:
Anti-vaping research drowns out harm reduction advocates in Australia
Wearable sensor measures airborne nicotine exposure from e-cigarettes
Australia: New laws won’t drive vapers back to smoking, say experts
Vaping raises chances of regular smoking threefold — Australian research review
Alarming results from New Zealand’s biggest youth vaping survey